多模态神经导航联合术中荧光导向技术在脑功能区高级别胶质瘤中的应用
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江苏省自然科学基金(BK20161140);无锡市卫生局重大项目(Z201301);无锡市科技发展计划项目(CSE31N1401)


Application of multimodal neuronavigation combined with intraoperative fluorescence guided technique in the high grade glioma of functional areas
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    摘要:

    目的:探讨多模态神经导航联合术中荧光导向技术在脑功能区高级别胶质瘤中的应用价值。方法:统计完整脑功能区胶质瘤60例患者资料,分为对照组和观察组,对照组为常规开颅手术组,观察组利用多模态神经导航系统联合荧光导向技术,术中在不同距离处和不同染色区域收集肿瘤标本,做相应病理分型和免疫组化分析,并比较两组肿瘤全切率和术后功能神经障碍情况,分析两者对患者预后的影响。结果:观察组均顺利实现功能技术融合和术中导航,术中荧光可见明显不同染色区域,两组胶质瘤病理分型差异无统计学意义,两组高级别胶质瘤全切率、术后功能神经障碍情况、术后前3个月肿瘤复发情况比较差异有统计学意义。不同距离处肿瘤标本免疫组化分析各指标表达可见明显变化趋势,荧光染色区域与术后病理特征相符。结论:多模态神经导航联合术中荧光导向技术可提高脑功能区高级别胶质瘤全切率,改善神经术后功能情况和患者预后。

    Abstract:

    Objective:To investigate the application of multimodal neuronavigation combined with intraoperative fluorescence guided technique in the high grade glioma of functional areas. Methods:Sixty patients were divided into the control group and the observation group. The control group received conventional craniotomy operation and the observation group operated by multimodal neuronavigation combined with intraoperative fluorescence guided technique. We collected tumor specimen at different distances and different staining region,and analyzed pathology and immunohistochemistry of these specimens. The total resection rate of tumor and nerve function disorder after operation was compared between two groups. The influence on prognosis of the patients was analyzed. Results:The observation group was successfully achieved preoperative function fusion and intraoperative navigation. Intraoperative fluorescence showed different staining regions. The pathological type of the two groups had no significantly difference. There was significant difference of high grade glioma resection rate and postoperative neurological function disorder and tumor recurrence of postoperative 3 mon between the two groups. Each index of immunohistochemical expressed significant changes in the trend at different distance of tumor specimens. The fluorescence staining area was consistent with the postoperative pathology. Conclusion:Multimodal neuronavigation combined with intraoperative fluorescence guided technique can improve the total resection rate of high grade glioma in brain function areas,and improve postoperative nerve function.

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黄 进,张晓路,张岩松,冯素银,黄维一,程 超,焦建同,兰 青,邵君飞.多模态神经导航联合术中荧光导向技术在脑功能区高级别胶质瘤中的应用[J].南京医科大学学报(自然科学版),2018,(1):14-19

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  • 收稿日期:2017-09-14
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  • 在线发布日期: 2018-02-02
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